LANDEN BROCK PT, DPT
NPI 1356027973
Physical Therapist in Tucker, GA

Active since June 27, 2023
2138 DILLARD XING, TUCKER, GA 30084(205) 480-4466 Get Directions Write a Review

NPPES record last updated: June 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Landen Brock Pt, Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LANDEN BROCK PT, DPT (NPI 1356027973) is an individual physical therapist in Tucker, Georgia, licensed in Georgia (PTO16664) and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1356027973
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameLANDEN BROCKCredential: PT, DPT
Location Address2138 DILLARD XINGTucker, GA 30084-5878
Mailing Address2138 Dillard XingTucker, GA 30084-5878 · (205) 480-4466
Sole ProprietorNo
Enumeration DateJune 27, 2023
NPPES CertifiedJune 27, 2023
✔ NPI 1356027973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in GA · PTO16664
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
2138 DILLARD XING, Tucker, GA 30084

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Landen Brock Pt, Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Landen Brock reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapy
3125 BLUE LAKE DR
Vestavia, AL 35243
  • Reassigned Medicare billing, Alabama enrollment
  • 12 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Landen Brock's NPI number?

The NPI number for Landen Brock is 1356027973. It was assigned to this individual provider in the NPPES registry on June 27, 2023.

Where is Landen Brock located?

Landen Brock practices at 2138 Dillard Xing, Tucker, GA 30084. The listed phone number is (205) 480-4466.

What is Landen Brock's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Landen Brock enrolled in Medicare?

Yes. Landen Brock is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Landen Brock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Landen Brock reassigns Medicare benefits to Agile Physical Therapy, LLC (Vestavia, AL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Landen Brock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Landen Brock was last updated on June 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.